Resultados da abordagem transeptal para a valva mitral com coração batendo

Abstract

Results of beating heart mitral valve surgery via the trans-septal approachResultados da abordagem transeptal para a valva mitral com coração batendo Resumo Objetivo: A cirurgia da valva mitral pode ser feita via transatrial ou transeptal. Embora a transatrial seja a preferida, a via transeptal tem sido utilizada mais recentemente e tido um grande valor nas operações com o coração batendo. Mostramos a nossa experiência na cirurgia da valva mitral via transeptal com coração batendo e discutimos seus benefícios e problemas. AbstractObjective: Mitral valve surgery can be performed through the trans-atrial or the trans-septal approach. Although the trans-atrial is the preferred method, the trans-septal approach has also been used recently and has a particular value in beating-heart mitral valve surgery. Herein we report our experience with beating-heart mitral valve surgery via trans-septal approach, and discuss its advantages and pitfalls.Methods: Between 2000 and 2007, 214 consecutive patients were operated upon utilizing beating heart technique for mitral valve surgery. The operation was performed via transseptal approach with the aorta unclamped, the heart beating, with normal electrocardiogram and in sinus rhythm.Results Rev Bras Cir Cardiovasc 2009; 24(1): 4-10 and 83 (38.8%) females. Of the prostheses used, 108 (50.5%) were biological, and 39 (18.2%) were mechanical. Mitral repairs were performed in 67 (31.3%) patients. Mean hospital stay was 17.4 ± 20.0 days (range: 3-135 days; median: 11 days). Intra-aortic balloon pump (IABP) utilization was required in 12 (5.6%) of 214 patients. One-month mortality was 7.4%, and re-operation for bleeding was needed in 15 (7%) patients.

Cirurgia cardíaca videoassistida

“…Best surgical times, not compromised venous drainage and repair of the septum by periods of traction without the need for atrial retractors were observed and reported in summary of study presented by our team in recent conference [42]. In surgery with sternotomy, this access has also been reviewed, offering the same benefits that we observed [43]. Navia et al [30], in their report with minimally invasive surgery in 1996 had demonstrated the use of the transseptal access in their procedures for treatment of mitral valve.…”

A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

“…Santana Filho evaluated patients undergoing mitral valve replacement with crossed papillopexy with echocardiography 30. Salerno et al described the results of beating heart mitral valve surgery via the trans-septal approach 31. Dalva et al described initial results of intermittent annular reduction with Alfieri’s repair for the treatment of mitral insufficiency in children 32.…”

Mid-Term Outcomes of Beating Heart Mitral Valve Replacement in Secondary Mitral Regurgitation with Poor Left Ventricular Function

“…The presence of a minor aortic leak can significantly interfere with the exposure and the course of the procedure. Salerno used a trans-septal approach for clampless beating heart mitral valve surgery in 214 patients to reduce aortic insufficiency and improved visualization of the mitral apparatus [20]. To counteract this discomfort, Ricci published a technique for continuous coronary perfusion, combining the retrograde and anterograde routes with aortic cross-clamping, which allowed him to perform beating heart polyvalvular surgery [21].…”